Kerin M J, Greenstein D, Chisholm E M, Sheehan S J, Kester R C
Department of Surgery, St James's University Hospital, Leeds.
Ann R Coll Surg Engl. 1992 Jul;74(4):274-6.
Antibiotic prophylaxis is indicated for patients undergoing amputation for severe ischaemia or gangrene. However, the adequacy of tissue levels of antibiotics in ischaemic tissue is not known. In this study the serum and tissue antibiotic levels were measured after intravenous administration of metronidazole (15 mg/kg body weight) and cephradine (20 mg/kg body weight). In 11 patients, venous samples were taken at time 0 (induction of anaesthesia) 10, 30 and 60 min. Samples of 2 g each of fat and muscle were collected from the amputation site and three distal sites. Metronidazole and cephradine levels were measured and the degree of limb ischaemia estimated preoperatively by an isotope limb blood flow method. Our results indicate that both metronidazole and cephradine penetrate ischaemic tissues to levels equivalent of a Mean Inhibitory Concentration (MIC) 50 for most organisms encountered in vascular surgery, and that the degree of ischaemia does not alter this.
对于因严重缺血或坏疽而接受截肢手术的患者，需要进行抗生素预防。然而，缺血组织中抗生素的组织水平是否充足尚不清楚。在本研究中，静脉注射甲硝唑（15mg/kg体重）和头孢拉定（20mg/kg体重）后，测定了血清和组织中的抗生素水平。对11例患者，在时间0（麻醉诱导）、10、30和60分钟采集静脉血样。从截肢部位和三个远端部位各采集2g脂肪和肌肉样本。测定甲硝唑和头孢拉定水平，并在术前通过同位素肢体血流法估计肢体缺血程度。我们的结果表明，甲硝唑和头孢拉定都能穿透缺血组织，达到血管手术中大多数常见微生物的平均抑制浓度（MIC）50水平，并且缺血程度不会改变这一情况。
